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de Jong FJ, Brinkman P, Wingelaar TT, van Ooij PJA, van Hulst RA. Pulmonary oxygen toxicity breath markers after heliox diving to 81 metres. Diving Hyperb Med 2023; 53:340-344. [PMID: 38091594 PMCID: PMC10944665 DOI: 10.28920/dhm53.4.340-344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023]
Abstract
Pulmonary oxygen toxicity (POT), an adverse reaction to an elevated partial pressure of oxygen in the lungs, can develop as a result of prolonged hyperbaric hyperoxic conditions. Initially starting with tracheal discomfort, it results in pulmonary symptoms and ultimately lung fibrosis. Previous studies identified several volatile organic compounds (VOCs) in exhaled breath indicative of POT after various wet and dry hyperbaric hypoxic exposures, predominantly in laboratory settings. This study examined VOCs after exposures to 81 metres of seawater by three navy divers during operational heliox diving. Univariate testing did not yield significant results. However, targeted multivariate analysis of POT-associated VOCs identified significant (P = 0.004) changes of dodecane, tetradecane, octane, methylcyclohexane, and butyl acetate during the 4 h post-dive sampling period. No airway symptoms or discomfort were reported. This study demonstrates that breath sampling can be performed in the field, and VOCs indicative of oxygen toxicity are exhaled without clinical symptoms of POT, strengthening the belief that POT develops on a subclinical-to-symptomatic spectrum. However, this study was performed during an actual diving operation and therefore various confounders were introduced, which were excluded in previous laboratory studies. Future studies could focus on optimising sampling protocols for field use to ensure uniformity and reproducibility, and on establishing dose-response relationships.
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Affiliation(s)
- Feiko Jm de Jong
- Royal Netherlands Navy Diving and Submarine Medical Centre, 1780 CA, Den Helder, The Netherlands
- Department of Anesthesiology, Amsterdam University Medical Center, location AMC, 1100 DD, Amsterdam, The Netherlands
- Corresponding author: Feiko JM de Jong, Royal Netherlands Navy Diving and Submarine Medical Centre, Rijkszee-en Marinehaven, Postbus 10.000, 1780 CA, Den Helder, The Netherlands, ORCiD: 0009-0008-9804-8307,
| | - Paul Brinkman
- Department of Pulmonology, Amsterdam University Medical Center, location AMC, 1100 DD, Amsterdam, The Netherlands
| | - Thijs T Wingelaar
- Royal Netherlands Navy Diving and Submarine Medical Centre, 1780 CA, Den Helder, The Netherlands
- Department of Anesthesiology, Amsterdam University Medical Center, location AMC, 1100 DD, Amsterdam, The Netherlands
| | - Pieter-Jan Am van Ooij
- Royal Netherlands Navy Diving and Submarine Medical Centre, 1780 CA, Den Helder, The Netherlands
- Department of Pulmonology, Amsterdam University Medical Center, location AMC, 1100 DD, Amsterdam, The Netherlands
| | - Robert A van Hulst
- Department of Anesthesiology, Amsterdam University Medical Center, location AMC, 1100 DD, Amsterdam, The Netherlands
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